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Opening Statement of
U.S. Senator Michael B. Enzi (R-WY), Chairman

Joint Hearing before the
Committee on Indian Affairs
and the
Committee on Health, Education, Labor, and Pensions
S. 1057, The Indian Health Care Improvement Act Amendments of 2005

July 14, 2005

Good afternoon. Thank you for coming to today’s joint hearing on the Indian Health Care Improvement Act.

There is no greater challenge before us in the Congress than the work we must do to continue to improve the quality of the health care that is available to those living on Reservations. Unfortunately, it seems that no matter how much progress we make, there is always more to do. Today’s hearing will enable us to chart our current progress and discuss what we can do to increase the services that are available to address the physical and emotional problems that continue to plague American Indians and Alaska Natives.

When the Indian Health Care Improvement Act was first signed into law in 1976, it was written to address the findings of surveys and studies that indicated that the health status of American Indians and Alaska Natives was far below that of the general population. It continues to be a matter of serious concern that, as the health status of most Americans continues to rise, the status of American Indians and Alaska Natives has not kept pace with the general population.

Studies show that American Indians and Alaska Natives die at a higher rate than other Americans from alcoholism, tuberculosis, auto accidents, diabetes, homicide and suicide.

In addition, a safe and adequate water supply and waste disposal facilities, something we all take for granted, isn’t available in 12 percent of American Indian and Alaska Native homes – as opposed to 1 percent of the general population. Several years ago, residents on the Wind River Reservation in Central Wyoming faced a drinking water shortage that threatened the health and safety of everybody in the area. Canned drinking water had to be donated to tribal members and local residents. The lack of these basic services makes life even more harsh for these people and contributes to those already high rates of death.

Coming from Wyoming, I know full well the problems we encounter in the effort to provide quality health care to all the people of my home state. That is why I have always made it one of my goals to help bring that perspective to the hearings and floor debates we have on the issues that affect the people of my state.

When I was first elected to the Senate in 1996 I knew that quality of life issues on the Reservations in Wyoming and throughout the country would continue to be a top priority of mine. I also knew that, in order to make life better for those living on the Wind River Indian Reservation specifically, and other Reservations nationwide, my staff and I would need to be intensely committed to taking the issues head-on and looking for creative ways to solve complicated problems.

That is why I put someone on my staff who already had a great deal of experience with these issues and shared my commitment to act on them. His name is Scotty Ratliff and he served with me in the Wyoming Legislature. I tasked him with the challenge of helping me to find solutions to the problems on our Reservations that would be both progressive and culturally sensitive.

Tribal leaders are already committed to making things better on their Reservations and I congratulate them on their vision and the hard work they have put into making it a reality. My only question continues to be, “How can I help?”

In the years since I have been in the Senate I have made numerous trips to the Wind River Reservation in Wyoming and met and spoke with the residents and tribal leaders. We all want the same goal – a better life for those who live there. I am confident that working together we will continue to make the kind of progress we must make if we are going to find effective and efficient ways to address the problems that continue to plague those living on our Reservations across the country.

As I noted during my visits to the Wind River Reservation, their problems are not unique to them. To have an impact on all those who live on Reservations from coast to coast, we will need to take a varied approach to address each of these problems separately. Clearly, people of different ages have different problems. A multi-faceted approach to solving each of their problems will require a systemic, as well as a financial approach.

Local, state and national governments and agencies must work together with tribal leaders to focus our resources where they will do the most good. That kind of approach has the greatest chance of being successful.

Earlier this year the HELP Committee held hearings on the nomination of Michael Leavitt to serve as Secretary of Health and Human Services. I believe we are fortunate to have Michael Leavitt at the helm of an agency that oversees the health care needs of the people of Reservations all across the country. I am also pleased Dr. Charles Grim is here with us today. Dr. Grim has an important job to do as the Director of Indian Health Services and he knows firsthand the level of dedication it will take to steadily improve health care for all American Indians. Dr. Grim has an unmatched understanding of the needs of Native Americans that you can’t get from reading reports and memos from people out in the field. I have every confidence in his willingness and his ability to be an important part of the solution to the health care needs of those on our Reservations and beyond.

Again -- the good news is – we’re making progress. As we do, we continue to find so much more that needs to be done. How do we best provide the assistance that is needed effectively and efficiently? That is the challenge that lies before us.

As we begin to hear from our witnesses, I would like to acknowledge and thank them all for their willingness to share their experiences with us so that we might craft a more effective bill to address the health care needs of our American Indian and Alaskan Native population.

I would also like to welcome Mr. Richard Brannan, the Chairman of the Northern Arapaho Business Council of Fort Washakie, Wyoming. No one knows better than he does the problems faced by those living on Reservations and by those who rely on the Indian Health Service for their healthcare needs. No one understands better than he does the necessity of making progress in addressing the health disparities experienced by American Indians. Most important of all, no one is more committed than he is to making a difference in the lives of all those who live on the Reservation.

I know he has an important message to share with us based on his experience and background with all those who live on the Wind River Reservation. I look forward to his comments and those of our entire list of witnesses. Each of you has a perspective and a point of view to share that only you can provide. I look forward to hearing a summary of your prepared remarks so we can address the underlying issues during our question and answer session.